Zuckerman Katharine E, Boudreau Alexy Arauz, Lipstein Ellen A, Kuhlthau Karen A, Perrin James M
Department of Pediatrics, Center for Child and Adolescent Health Policy, MassGeneral Hospital for Children, Harvard Medical School, Boston, Mass., USA.
Acad Pediatr. 2009 Mar-Apr;9(2):97-105. doi: 10.1016/j.acap.2008.12.006.
Provider elicitation of parent developmental and behavioral (DB) concerns is the foundation of DB surveillance. Language differences may affect whether providers assess parental DB concerns.
The aim of this study was to compare children in English versus Spanish primary language households by risk for DB disorder and provider elicitation of parental developmental and behavioral concerns.
The 2003 National Survey of Children's Health was used to compare 29,692 children, aged 0 to 71 months, who received preventive care in the previous 12 months and were in English versus Spanish primary language households. Using logistic regression, we tested the association of household primary language with child risk of developmental and behavioral disorder and parent-reported elicitation of developmental and behavioral concerns at health care visits.
After adjusting for sociodemographic differences, children in Spanish primary language households were less likely than children in English primary language households to be at risk for DB disorder (40.5% vs 40.8%; AOR [adjusted odds ratio] 0.68, 95% confidence interval [CI], 0.55-0.85). Parents in Spanish primary language households reported less provider elicitation of developmental and behavioral concerns compared to all English primary language households (31.0% vs 43.7%; AOR 0.70, 95% CI, 0.57-0.85), but similar rates of elicitation compared to Hispanic English primary language households. Among households with children at moderate/high risk for DB disorder, parents in Spanish primary language households reported less elicitation of concerns than parents in English primary language households (AOR 0.63, 95% CI, 0.41-0.96).
Parents in Spanish primary language households reported lower child risk for developmental and behavioral disorder and less provider elicitation of developmental and behavioral concerns. These findings suggest that primary language may affect risk for developmental and behavioral disorder and likelihood of DB surveillance in children.
医疗服务提供者对家长关于儿童发育和行为（DB）问题的询问是DB监测的基础。语言差异可能会影响医疗服务提供者是否评估家长对DB问题的关注。
本研究的目的是比较以英语和西班牙语为主要语言家庭中的儿童患DB障碍的风险以及医疗服务提供者对家长关于儿童发育和行为问题的询问情况。
2003年全国儿童健康调查用于比较29692名年龄在0至71个月之间、在过去12个月接受过预防保健且分别以英语和西班牙语为主要语言家庭的儿童。使用逻辑回归，我们测试了家庭主要语言与儿童发育和行为障碍风险以及家长报告的在医疗就诊时对发育和行为问题的询问之间的关联。
在调整社会人口统计学差异后，以西班牙语为主要语言家庭中的儿童患DB障碍的风险低于以英语为主要语言家庭中的儿童（40.5%对40.8%；调整后的优势比[AOR]为0.68，95%置信区间[CI]为0.55 - 0.85）。与所有以英语为主要语言的家庭相比，以西班牙语为主要语言家庭的家长报告医疗服务提供者对发育和行为问题的询问较少（31.0%对43.7%；AOR为0.70，95% CI为0.57 - 0.85），但与西班牙裔以英语为主要语言的家庭相比，询问率相似。在DB障碍风险为中度/高度的儿童家庭中，以西班牙语为主要语言家庭的家长报告的问题询问少于以英语为主要语言家庭的家长（AOR为0.63，95% CI为0.41 - 0.96）。
以西班牙语为主要语言家庭的家长报告其孩子患发育和行为障碍的风险较低，且医疗服务提供者对发育和行为问题的询问较少。这些发现表明主要语言可能会影响儿童发育和行为障碍的风险以及DB监测的可能性。
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